Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
The Clinical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Front Immunol. 2022 May 3;13:893929. doi: 10.3389/fimmu.2022.893929. eCollection 2022.
To examine the levels of 1-palmitoyl-2-(5-oxovaleroyl)-sn-glycero phosphatidylcholine (POVPC) and 1-palmitoyl-2-glutaroyl-sn-glycero-phosphatidylcholine (PGPC) (the oxidized phosphatidylcholines) in HDL during the course of sepsis and to evaluate their prognostic value.
This prospective cohort pilot study enrolled 25 septic patients and 10 healthy subjects from 2020 to 2021. The HDLs were extracted from patient plasmas at day 1, 3 and 7 after sepsis onset and from healthy plasmas (total 81 plasma samples). These HDLs were then subjected to examining POVPC and PGPC by using an ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS) system. We further measured the levels of 38 plasma cytokines by Luminex and evaluated the correlation of HDL-POVPC level with these cytokines. Patients were further stratified into survivors and non-survivors to analyze the association of HDL-POVPC level with 28-day mortality.
Septic patients exhibited significant increase of HDL-POVPC at day 1, 3 and 7 after sepsis onset (POVPC-D1, p=0.0004; POVPC-D3, p=0.033; POVPC-D7, p=0.004, versus controls). HDL-PGPC was detected only in some septic patients (10 of 25) but not in healthy controls. Septic patients showed a significant change of the plasma cytokines profile. The correlation assay showed that IL-15 and IL-18 levels were positively correlated with HDL-POVPC level, while the macrophage-derived chemokine (MDC) level was negatively correlated with HDL-POVPC level. Furthermore, HDL-POVPC level in non-survivors was significantly increased versus survivors at day 1 and 3 (POVPC-D1, p=0.002; POVPC-D3, p=0.003). Area under ROC curves of POVPC-D1 and POVPC-D3 in predicting 28-day mortality were 0.828 and 0.851. POVPC-D1and POVPC-D3 were the independent risk factors for the death of septic patients (p=0.046 and 0.035).
HDL-POVPC was persistently increased in the course of sepsis. POVPC-D1 and POVPC-D3 were significantly correlated with 28-mortality and might be valuable to predict poor prognosis.
检测脓毒症病程中高密度脂蛋白（HDL）中 1-棕榈酰-2-（5-氧代戊酰基）-sn-甘油磷酸胆碱（POVPC）和 1-棕榈酰-2-戊二酰基-sn-甘油磷酸胆碱（PGPC）（氧化的磷脂酰胆碱）的水平，并评估其预后价值。
本前瞻性队列研究纳入了 2020 年至 2021 年期间的 25 例脓毒症患者和 10 例健康对照者。从脓毒症发病后第 1、3 和 7 天的患者血浆中提取 HDL，并从健康血浆中提取（共 81 份血浆样本）。然后使用超高效液相色谱-串联质谱（UHPLC-MS/MS）系统检测 POVPC 和 PGPC 的水平。我们还通过 Luminex 测量了 38 种血浆细胞因子的水平，并评估了 HDL-POVPC 水平与这些细胞因子的相关性。进一步将患者分层为存活者和非存活者，以分析 HDL-POVPC 水平与 28 天死亡率的关系。
脓毒症患者在脓毒症发病后第 1、3 和 7 天 HDL-POVPC 水平显著升高（POVPC-D1，p=0.0004；POVPC-D3，p=0.033；POVPC-D7，p=0.004，与对照组相比）。HDL-PGPC 仅在部分脓毒症患者（25 例中的 10 例）中检测到，而在健康对照者中未检测到。脓毒症患者的血浆细胞因子谱发生显著变化。相关性分析显示，IL-15 和 IL-18 水平与 HDL-POVPC 水平呈正相关，而巨噬细胞来源的趋化因子（MDC）水平与 HDL-POVPC 水平呈负相关。此外，非存活者在第 1 和第 3 天的 HDL-POVPC 水平明显高于存活者（POVPC-D1，p=0.002；POVPC-D3，p=0.003）。POVPC-D1 和 POVPC-D3 预测 28 天死亡率的 ROC 曲线下面积分别为 0.828 和 0.851。POVPC-D1 和 POVPC-D3 是脓毒症患者死亡的独立危险因素（p=0.046 和 0.035）。
HDL-POVPC 在脓毒症病程中持续升高。POVPC-D1 和 POVPC-D3 与 28 天死亡率显著相关，可能对预测不良预后有价值。
